한국 노인의 수산물 섭취와 노쇠와의 상관성 연구

Abstract

노쇠는 노인단계로 접어들수록 신체기관에 작용하는 생리적 저장능이 감소된다. 이는 삶의 질 저하, 입원 및 사망 위험률이 증가된다. 하지만 노쇠는 치료 및 예방이 가능한 증후군으로 알려져 있다. 수산물에는 불포화지방산을 포함한 항산화와 관련된 영양소가 풍부한 것으로 알려져 있다. 그럼에도 불구하고 한국 노인을 대상으로 수산물섭취에 따른 노쇠와의 연관성을 규명한 과학적인 기초 연구자료는 매우 부족하다. 따라서 한국 노인의 수산물섭취량을 파악하고 수산물 섭취와 노쇠와의 상관성이 있는지 알아보고자 수행하였다. 본 연구는 제 7기 (2016-2018년) 국민건강영양조사에 참여한 65세 이상 노인 3,674명 (남성 1,643명, 여성 2,031명) 대상으로 연구가 진행되었다. 노쇠를 평가하는 척도는 Fried가 고안한 방법을 이용하여 의도하지 않은 체중감소, 근력약화 (grip strength), 보행속도 감소, 극도의 피로감 (self-reported exhaustion), 신체활동 감소의 5가지 항목 중 0개는 건강군 (robust), 1-2개는 전노쇠군 (pre-frail), 3개 이상 해당할 경우 노쇠군 (frail)으로 정의하였다. 성별에 따른 노쇠 유병률은 남성은 12.9%, 여성은 26.4%로 여성의 비율이 유의하게 높았다. 대상자 조사 1일 전 24시간회상법 자료를 이용하여 노쇠 수준으로 갈수록 여성에게서 어패류와 수산물섭취량이 유의적으로 적었다. 남녀 모두 수산물섭취에 따른 1,000 kcal 당 15가지 영양소섭취량 (단백질, 지방, 식이섬유, 비타민 A, 베타카로틴, 비타민 B1, 비타민 B2, 나이아신, 비타민 C, 칼슘, 칼륨, 인, 철, 나트륨, 엽산)과 불포화지방산 섭취량 (MUFA, PUFA, ω-3계, ω-6계 지방산)은 유의하게 높았다. 수산물섭취가 높을수록 남녀 모두 1,000 kcal 당 탄수화물섭취량과 탄수화물섭취 비율은 유의적으로 낮았다. 식품군섭취에서는 수산물섭취가 높을수록 남녀 모두 곡류, 감자 전분류, 당류를 함께 섭취한 식품군과 채소류, 버섯류, 과일류를 함께 섭취한 식품군 섭취량이 유의하게 높은 반면, 남성에게서만 적색육 섭취량이 유의하게 낮았다. 수산물섭취에 따른 노쇠 위험도는 여성에게서 하위1사분위군 보다 상위4사분위군에서 수산물 [OR (95% CI) = 0.52 (0.30-0.90)] 섭취에서 낮은 노쇠 위험도를 보여주었다. 본 연구에서는 수산물섭취에 따른 노쇠와의 상관성을 규명하였다. 전체연구대상자 중 여성에게서 수산물섭취가 높을수록 노쇠의 발병 위험이 낮은 상관성이 있음을 제시하였다. ;Frailty is a physiological reserves reduction that acts on multiple organ systems as entering the elderly stage. And Physiological, physical, and mental homeostasis decrease due to response internal and external stressors. It is associated with high-risk quality of life deterioration, disability, hospitalization, and mortality in older adults. Previous studies have reported that frailty may be prevented or treated. Seafood contains functional components that are not present in terrestrial organisms. These components include polyunsaturated fatty acids, such as ω-3 and ω-6 fatty acids, which aid in the prevention of aging. In addition, seafood is a superior source of various nutrients, such as protein, amino acids, fiber, vitamins, and minerals. Nevertheless, few studies have shown the relationship of frailty with seafood intake among the Korean elderly. The purpose of this study was to investigate the association between frailty and seafood intake in the Korean elderly. This study was used raw data from the Seventh (2016-2018) Korea National Health and Nutrition Examination Survey. Study subjects were 3,674 (1,643 men and 2,031 women). Frailty was measured using a minor modification of the operational definition of frailty developed by Fried and colleagues. Robust was defined as having none of the following five criteria including unintentional weight loss, weakness, walking difficulties, exhaustion, and low physical activity. Pre-frail was defined as having one or two criteria. Frailty was defined as having three or more of the following five criteria. In this study, 12.9 percent of men and 26.4 percent of women were classified as frail groups. The prevalence of frailty was significantly higher in women than in men. Dietary and seafood intake was assessed by a one-day 24-hr dietary recall. Fish and shellfish, and seafood intake were significantly low in frail women. The 15 kinds of nutrients density ( protein, fat, dietary fiber, vitamin A, beta-Carotene, vitamin B1, vitamin B2, niacin, Vitamin C, calcium, phosphorus, potassium, iron, sodium, folate ) and polyunsaturated fatty acids density ( MUFA, PUFA, ω-3, ω-6 fatty acid ) were significantly high in the highest quartiles compared with the lowest quartiles seafood intake in men and women. However, the Carbohydrate density and Carbohydrate ratio were significantly low in the highest quartiles compared with the lowest quartiles of seafood intake. In Dietary groups, the food group that consumed all grains, potato starch, and sugars and the food group that consumed all vegetables, mushrooms, and fruits were significantly high in the highest quartiles compared with the lowest quartiles of seafood intake in men and women. However, Red meat intake was significantly low in the highest quartiles compared with the lowest quartiles of seafood intake in men. In seafood intake and protein intake from seafood, The frailty score was significantly low in the highest quartiles compared with the lowest quartiles of seafood and seafood protein intake in men and women. In protein intake ratio from seafood, only women's Frail score was significantly low in the highest quartiles compared with the lowest quartiles of seafood protein intake ratio. To investigate the association between frailty and seafood intake, variables including age, BMI, residential area, household income, alcohol consumption, physical activity, and energy intake were adjusted. In women, the odds ratio (95% CI) of frailty for those in the highest quartiles compared with the lowest quartiles of seafood intake was 0.52 (0.30-0.90). In conclusion, the present study demonstrated sex-related differences in the association between dietary seafood intake and frailty.